The Foolproof Way to Stop High Cortisol (in literally minutes)
This video explores the science behind chronic cortisol elevation, its devastating effects on your body and mitochondria, and practical strategies to break the sympathetic nervous system spiral. Dr. Scott Sherr explains why simply telling yourself to "calm down" doesn't work and offers evidence-based solutions including GABA optimization, methylene blue supplementation, and strategic carbohydrate timing.
1. What Cortisol Really Is (And Why You Need It) 🧠
Dr. Scott Sherr kicks off by addressing a common misconception about cortisol:
"Cortisol gets vilified... people think, oh, cortisol is bad, but we need cortisol. If you don't have any cortisol, you're going to die."
Cortisol is your stress hormone, and it's absolutely essential for regulating your stress response. The problem isn't cortisol itself—it's the chronic elevation that modern society creates. Cortisol is designed to spike during acute stress and then come back down. But when you're constantly stuck in fight or flight mode, cortisol stays elevated far longer than it should.
Your nervous system has two main branches: the sympathetic nervous system (fight or flight) and the parasympathetic nervous system (rest and digest). When your sympathetic system gets locked in the "on" position, cortisol remains chronically elevated.
In the short term, cortisol is actually fantastic—it boosts your neurotransmitters like norepinephrine and epinephrine, giving you energy when you need it most. It also dumps fat and sugar into your bloodstream so you can fuel your brain and muscles if you need to run from danger.
"However, many people are living with that dumping of fat and sugar into their bloodstream all the time because they're always in fight or flight."
This leads to increased visceral fat—the dangerous fat around your organs that we evolved to store for times of famine. Your body is essentially preparing for a crisis that never ends.
2. The Importance of Sympathetic Reserve 📊
One of the most important concepts Dr. Sherr introduces is sympathetic reserve—essentially, how much capacity you have left to respond to stress.
"If you're already at a stressed level, there's not a whole lot more you can go."
Think of it like this: if your stress baseline is already near the top, you have very little room to spike when you actually need to perform. But if your baseline is low, you have much more delta—that crucial difference between your resting state and your peak performance state.
"That's where everything changes. That's where muscle growth change. That's where you get hypertrophy. That's where you get your endurance. Your VO2 max goes up. It's that change that you need."
This delta is where all the magic happens. When you're chronically in fight or flight, you can't recover properly. And recovery is when you actually build muscle, strengthen your immune system, and repair your body.
"You don't make your gains in the gym... you make your gains after you've gotten out of the gym and you're getting into that parasympathetic mode, which is rest, digest, detoxify, and recover."
Here's an important point about cortisol: it's a catabolic hormone, meaning it breaks you down rather than building you up. When cortisol is chronically high, your anabolic hormones—testosterone, growth hormone, and insulin—all get suppressed. This creates a perfect storm for muscle loss, poor recovery, and metabolic dysfunction.
3. The Immune System Connection 🛡️
The immune system follows the same principle. When you're chronically stressed, you lose that crucial delta for immune response too.
Dr. Sherr explains a phenomenon many people have experienced:
"The common thing is that you go on vacation and you get sick. Why? Because you're finally going into parasympathetic mode and relaxing and your system's trying to detoxify."
When you're always in sympathetic mode, your immune system goes into a kind of hibernation. You might actually get sick more often, but when you finally try to relax, your body attempts to catch up on all that deferred maintenance—which can feel like getting sick.
"Your nervous system was supposed to go back and forth. And we just don't have that in modern society anymore."
4. Clinical Signs of Chronic Cortisol Elevation ⚠️
When Dr. Sherr sees patients with chronically elevated cortisol, several patterns emerge:
- Immune system dysregulation
- Dramatic increases in visceral fat around organs
- Mitochondrial dysfunction
The organs themselves have high numbers of cortisol receptors and can even produce their own cortisol. This means once cortisol is elevated, it preferentially increases visceral fat even compared to subcutaneous fat.
The Mitochondrial Cascade
When you're stuck in sympathetic overdrive, your mitochondria get hammered. They're constantly trying to produce more energy to meet the demands of your stressed state.
"We're more like a gasoline powered car... we make ATP, our energy currency, we make about 150 pounds of that every single day."
But with all that energy production comes reactive oxygen species (ROS)—essentially, cellular exhaust. While ROS serves as important signaling molecules in small amounts, chronic overproduction overwhelms your antioxidant defenses.
"Your mitochondria go and shift into a different hibernation stage called the cell danger response, which is a stage where they can't make energy effectively anymore because they're trying to protect themselves from all that oxidative damage."
This creates a vicious cycle: damaged mitochondria send out more stress signals, which ramps up sympathetic activation even further.
5. How Symptoms Actually Manifest 🔍
Initially, most people compensate without even realizing what's happening. But eventually, threshold symptoms appear—and they're almost always related to recovery:
"You don't recover as well after going on a flight. You don't recover as well after an argument with your spouse. You don't recover as well from the gym. It takes you a couple days to feel like you fully recovered."
Other common signs include:
- Energy fluctuations throughout the day
- Difficulty focusing
- Feeling "wired but tired"
- Mood instability
- Irritability with loved ones
"Your kids come home and say, 'Daddy, look at my homework,' and you start yelling at them for some reason... It's not them that's the issue."
Dr. Sherr notes that men are often less aware of how they're feeling, so he sometimes asks their partners for observations about recovery and mood changes.
6. Is Adrenal Fatigue Real? 🤔
Thomas asks the million-dollar question about adrenal fatigue—is it actually a thing, or is it just marketing hype?
"I think there's a spectrum here... there is some evidence that you can burn the adrenals over time for sure."
The adrenal glands produce cortisol through the hypothalamic-pituitary-adrenal (HPA) axis. After prolonged stress, cortisol production can actually decline—not to zero, but significantly lower than normal.
"Initially you'll see the cortisol rise in people as they're stressed all the time. But over time you do see it come down even if they're still in the stress mode because they can't make it as much anymore."
This is when people feel tired despite being stressed. Their norepinephrine and epinephrine are still pumping, but without adequate cortisol, those neurotransmitters don't work as effectively.
Dr. Sherr emphasizes that adrenal fatigue should be tested, not assumed. A healthy cortisol rhythm rises when you wake up and drops to its lowest point before bed. Flat cortisol throughout the day suggests burnout and indicates it's time to rebuild.
7. The Salt and Adrenal Connection 🧂
Thomas brings up a popular topic: does having salt in the morning actually support adrenal function?
"There's definitely the salt sensitivity, and salt itself is regulated by a different hormone, not cortisol directly. It's called a mineralocorticoid."
This hormone is also produced by the adrenals and works in concert with cortisol. When you consume salt, it increases blood pressure slightly through mineralocorticoid action—which can make you feel better, especially if you have low blood pressure.
Salt also helps with hydration because it allows water to enter the body more easily, increasing plasma volume and vascular tone. Combined with creatine in the morning, it could be particularly helpful.
"I'm a big fan of salt... actually what I found over the years is that sometimes they even need more salt than less."
8. Why "Just Breathe" Doesn't Work (And What Does) 💨
Here's where things get practical. Yes, nasal breathing and diaphragmatic breathing are genuinely effective:
"Deep diaphragmatic breaths are like 45 times more effective at that glymphatic [flow]"—the brain's waste-clearing system.
But let's be real:
"Tell somebody to breathe when they're really stressed, it just doesn't... even when they're not under stress, telling someone to breathe, they're like, 'Give me the real stuff.'"
The GABA Solution
The most effective immediate intervention Dr. Sherr has found is optimizing the GABA system through supplementation. GABA (gamma-aminobutyric acid) is your brain's primary inhibitory neurotransmitter—essentially the brakes of your brain.
"When you're in sympathetic overload all the time, you deplete your GABA, which increases your risk of anxiety, insomnia, mental health disorders, depression."
Interestingly, depression isn't actually a serotonin problem as doctors were taught for decades:
"There's no lower levels of serotonin in people with depression versus people that don't have depression, but there are lower GABA levels in people with depression."
Here's a wild statistic about your brain's thought generation:
"We have about 70,000 thoughts per day on average... But if you're GABA deficient, you're up to like 120,000 thoughts per day."
No wonder anxious people can't quiet their minds!
9. The Problem with GABA Supplements (And Better Alternatives) 💊
Here's something most people don't know:
"GABA as a supplement is too big to get across into the brain. If you take GABA supplements and they work for you, you probably have a leaky brain."
A "leaky brain" means your blood-brain barrier isn't functioning properly—often connected to leaky gut. Dr. Sherr has had patients where GABA supplements stopped working after they fixed their gut issues, which is actually a good sign.
Better Options for GABA Support
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Agaric (from Amanita muscaria mushroom) - Works on the GABA system with a long half-life (about 6.5 hours), great for sleep. At low doses, it's not psychedelic.
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Magnolia bark (Honokiol) - Another GABA system supporter
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Niacinamide-GABA (B3-GABA) - B3 has a transporter that crosses the blood-brain barrier, bringing GABA directly where it's needed
Why Alcohol and Benzos Are Problematic
Alcohol, benzodiazepines (Xanax, Valium), and sleep drugs like Ambien all work as positive allosteric modulators—they increase the affinity for GABA to bind. The problem? They deplete GABA in the process.
"If you're trying to feel better, you're actually over the long term going to be burning yourself even more... requiring more to get the same effect."
Where Does Kava Fit?
Kava works similarly to alcohol as a positive allosteric modulator, which is why it can help socially. Thomas shares his experience:
"I use it for social occasions because I'm not a social person... Kava makes me mildly tolerable to be around."
But there's a catch—Thomas notices a rebound effect about two days later:
"I get a glutamate surge at like 3:00 a.m. two days later."
The solution is creating an "obligate pair"—combining something that increases GABA affinity with a source of GABA simultaneously. This prevents the downstream tolerance, withdrawal, and dependence.
10. The Danger of Calming Down (Yes, Really) 😰
Here's something unexpected: when you've been in sympathetic overdrive for a long time, calming down can actually trigger anxiety.
"You may get reactive anxiety when your sympathetic nervous system starts coming off. Like, 'I don't know what to do... I need to be at this level of intensity to be able to do the things that I want to do.'"
Thomas relates this to his own experience after his first psychedelic session:
"I became such a seemingly calmer person that there was this extra room that my nervous system was like looking... it was just scanning and you could feel it scanning... My wife's just like, 'I'm waiting for you to react.'"
Your nervous system literally starts searching for threats because that's what it's been trained to do. Working through this transition is part of the process.
11. The Methylene Blue Protocol for Mitochondrial Support 💙
Dr. Sherr's clinical approach involves supporting the body before dramatically calming the nervous system.
"I'm actually not bringing down the nervous system first. I'm actually supporting the system first and then bringing down the nervous system so that when we bring it down that they're being supported."
How Methylene Blue Works
Methylene blue supports the mitochondria in a unique way:
"It's almost like more like an electric powered car than a gasoline powered car because it also can serve as its own capacity as an antioxidant."
When you make energy, you also make reactive oxygen species. But methylene blue allows you to produce more energy without generating as much oxidative stress—it's doing energy production and detoxification simultaneously.
The dosing starts very low—around 4, 8, or 12 milligrams:
"So much that they're not actually feeling a lot of energy from it... You're just giving them enough mitochondrial support."
After a couple weeks of titrating up the methylene blue, then Dr. Sherr introduces something to calm the nervous system. This sequence is crucial:
"If you just try to optimize somebody's mitochondria with methylene blue, for example, but they're in this sympathetic spiral, they're not going to work."
12. Carbohydrates to Blunt Cortisol 🍯
Here's a practical hack that might surprise some people: a quick bolus of carbohydrates can effectively shut off the sympathetic spiral.
"Insulin is what blunts cortisol—probably the strongest way to blunt cortisol."
Thomas uses 1-2 tablespoons of honey when really stressed, and it helps calm the cortisol response. Sports research supports this—carbohydrates don't seem to directly help muscle growth, but they downregulate sympathetic tone, allowing parasympathetic activation where growth hormone rises and recovery happens.
But there's an important caveat:
"How metabolically healthy are you? And then how much carbohydrates can you tolerate? And are you already insulin resistant?"
If you're already in a sympathetic spiral and your cortisol stays elevated for hours after a workout, adding carbs could worsen insulin resistance.
The simple test: Can you take 10-15 minutes to relax after your workout?
"If you're like, 'No, I'm full steam meetings all day. I'm going to do 10 workouts later. I'm going to go to the cold plunge and then I meet my buddies at the sauna and then we're going to do psychedelics tomorrow.' Like, no."
13. Why Traditional Approaches Often Fail 🏥
Dr. Sherr makes a sobering observation about why so many people never get better despite seeing multiple specialists:
"You have people that have gone to like seven doctors or 25 specialists and they never get better... because they're always in this sympathetic activation."
The key insight is that physiological optimization alone won't work if the nervous system isn't addressed. And nervous system work alone won't stick if the mitochondria and immune system aren't supported.
Performance Benefits of Calming Down
Here's something counterintuitive: calming your sympathetic nervous system actually improves performance:
"You actually decrease blood flow to the front of your brain when you're all in sympathetic all the time. And so your executive function, your memory, your recall, all that goes down."
This is why you might forget your lines during a presentation—your stressed brain isn't getting adequate blood flow to the prefrontal cortex.
Thomas mentions his experience with underwater training with Laird Hamilton and Gabby Reece:
"It's very opposite of what you would think... how do you stay very calm and how do you lower your heart rate and open your peripheral vision and just calm."
Using something to support the GABA system before these sessions makes a noticeable difference in performance.
Conclusion 🎯
Breaking the chronic cortisol cycle isn't about simply telling yourself to relax—it requires a strategic, multi-layered approach. The key takeaways:
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Understand sympathetic reserve - Your ability to handle stress depends on your baseline; if you're already maxed out, you have no room to adapt
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GABA optimization is crucial - But avoid compounds that deplete GABA (alcohol, benzos); instead, use obligate pairs that support GABA production while enhancing receptor activity
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Support mitochondria first - Low-dose methylene blue can help rebuild cellular energy capacity before attempting major nervous system changes
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Strategic carbohydrates can help - But only if you're metabolically healthy and can actually take time to relax post-workout
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Recovery is everything - You don't build muscle, heal, or strengthen your immune system while stressed; all the magic happens in the parasympathetic state
The sympathetic spiral affects everything—your body composition, immune function, mental clarity, relationships, and longevity. Addressing it requires understanding that both the nervous system and the underlying cellular damage need attention simultaneously.
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